Treatment of impetiginized eczema with prednicarbate in combination with a quarternary ammonium salt

After a brief account of the therapeutic problems with microbially superinfected eczemas, the results of a double-blind study of hospitalized patients are reported. Two concentrations of the antibacterial agent Bardac-22 (didecyl-dimethyl-ammonium chloride. Hoe S 2922) in combination with the steroid prednicarbate (prednisolone 17-(ethylcarbonate)-21-propionate, Hoe 777) were used. The quantitative determination of cutaneous bacteria was performed by a modified method of Faergemann. The double blind study did not reveal any significant differences in effectiveness, although a trend in favour of the higher concentration was apparent.     

Organic anion transporting polypeptide 2‐mediated uptake of paclitaxel and 2′‐ethylcarbonate‐linked paclitaxel in freshly isolated rat hepatocytes

Objectives The P‐glycoprotein (P‐gp) efflux pump plays an important role in paclitaxel detoxification. However, hepatic uptake of paclitaxel mediated by a solute‐linked carrier transporter family is still poorly understood in animals and humans. Freshly isolated hepatocyte suspensions are a well established in‐vitro model for studying drug transport and xenobiotic metabolism. Therefore, the hepatic uptake of paclitaxel and its P‐gp‐insensitive prodrug, 2′‐ethylcarbonate‐linked paclitaxel (TAX‐2′‐Et), has been characterized using freshly isolated and pregnenolone‐16‐α‐carbonitrile (PCN)‐treated hepatocytes in rats. Methods Paclitaxel and TAX‐2′‐Et were incubated with rat hepatocyte suspensions in the presence or absence of inhibitors. Key findings Paclitaxel and TAX‐2′‐Et showed concentration‐dependent uptake in rat hepatocytes. The intrinsic transport capacity was two‐fold higher for paclitaxel uptake than for TAX‐2′‐Et uptake. Rifampicin (a potent inhibitor of organic anion transporting polypeptide (Oatp) 2), but not indometacin (a representative inhibitor of organic anion transporter (Oat) 2 and Oatp1) treatment, significantly inhibited the uptake of paclitaxel and TAX‐2′‐Et. We characterized the rifampicin‐sensitive uptake of paclitaxel and TAX‐2′‐Et using rat hepatocytes treated with PCN, which dramatically enhances hepatic Oatp2 protein levels. PCN‐treated hepatocytes displayed a 1.6‐fold greater uptake of paclitaxel and TAX‐2′‐Et than the vehicle‐treated hepatocytes. The uptake of the two compounds was significantly reduced by rifampicin but not by indometacin treatment. These findings demonstrated that the rat Oatp2, but not Oatp1 orOat2, was a candidate transporter for the hepatic uptakeofpaclitaxel and TAX‐2′‐Et. Conclusions The findings have provided an important step towards identifying a key transporter in hepatic detoxification of paclitaxel and TAX‐2′‐Et in small animals.     

根据病因实施救治对昏迷患者预后的影响分析

目的探讨根据病因实施救治对昏迷患者预后的影响。方法选择我院2011年11月至2013年11月期间收治的昏迷病例共98例,上述患者分为观察组和对照组。对照组患者在施救过程中根据临床症状进行救治,观察组在救治过程中根据导致昏迷的相关病因针对性治疗。观察两组患者救治成功情况。结果观察组患者经过病因抢救后:好转28例、治愈23例、死亡9例,抢救成功患者共51例,抢救成功所占比例为85.0%;对照组患者根据症状抢救后:好转17例、治愈9例、死亡12例,抢救成功患者共26例,抢救成功所占比例为68.4%;观察组抢救成功所占比例高于对照组,差异有统计学意义(P<0.05)。结论根据病因进行救治能够显著提高昏迷患者抢救效果,值得借鉴。     

罗哌卡因在分娩镇痛中的应用

目的：观察不同浓度罗哌卡因（ropivacaine,Rop)用于分娩镇痛的临床效果,探索其理想的浓度和剂量。方法：随机选择ASAⅠ-Ⅱ级临产初产妇45例,平均分为三组：0．16％Rop组和0．2%Rop组作为观察组,以及对照组15例。观察组于宫口开至2－3cm时于L2－3间隙行硬膜外腔穿刺置管,以罗哌卡因维持镇痛;对照组未作分娩镇痛。围分娩镇痛期地监测血压（BP）、脉氧饱和度（SpO2)、EKG、PETCO2、宫缩及胎心音,记录产程时间：镇痛效果采用VAPS评分法进行疼痛评分,运动神经阻滞以Bromage分级评分;新生儿出生后1－5min进行Apgar评分,分娩后24h新生儿NACS评分。结果：围分娩期三组生命体征稳定;VAPS评分观察组较对照组明显降低,但0．2％Rop对运动神经的阻滞频率和程度最重,对宫缩有轻微的抑制,催产素用量相对增加;对产的影响均短于对照组,但差异不显著,三组对围分娩期胎心、Apgar评分无影响;分娩后24hNACS评分观察组较对照组增高明显;剖宫产率0．16％、Rop组最低。结论：罗哌卡因独特的感觉和运动阻滞明显分离,对子宫胎盘血流无明显影响,有利于分娩镇痛。0．2％Rop较0．16％对运动神经阻滞的频率和程度更重0．16％Rop对分娩镇痛是一种比较理想的局部麻醉药。     

我国肺结核病耐药状况的综合分析

目的分析近20年来肺结核病耐药情况,为临床治疗提供参考,为改进肺结核病防治措施提供科学依据。方法采取综合分析的方法对1990～2009年肺结核病耐药监测结果进行综合分析。结果 20年来的文献系统分析表明初始耐药率为30.1%,获得性耐药率为65.6%,总耐药率为43.8%;初始耐多药率为8.5%,获得性耐多药率为31.7%,总耐多药率为19.3%。2000-2009年间的初始耐药率、获得性耐药率和总耐药率以及初始耐多药率相对于1990至1999年间均有所下降,差异均有统计学意义。初始耐药以耐SM和INH最多,耐药率为40.9%和40.8%;获得性耐药和总耐药均以耐INH最多,耐药率分别为47.0%和30.4%。在初始耐药中,耐一药和耐多药的比例分别为47.7%和26.6%,差异有显著性。在获得性耐药中,耐一药和耐多药的比例分别为26.3%和49.3%,差异有显著性。结论我国初始耐药率、获得性耐药率以及总耐药率均处于较高水平,获得性耐药以耐多药为主,耐药形势十分严峻。     

2015-2017年耐碳青霉烯类肺炎克雷伯菌耐药变迁及流行调查

目的 了解河北医科大学第二医院2015-2017年耐碳青霉烯类肺炎克雷伯菌(carbapenem-resistant Klebsiella pneumoniae,CRKP)变迁及流行特征,并进行流行病学分析。方法 采用Vitek 2-Compact进行细菌鉴定和药物敏感试验测定,使用Whonet 5.6软件及SPSS 5.0进行数据统计分析,PCR扩增碳青霉烯酶基因blaKPC-2和blaNDM-1;对有流行病学意义的菌株进行多位点序列分型(MLST),目的产物经基因测序和BLAST网上比对确定其基因型。结果 2015-2017年共检出肺炎克雷伯菌非重复菌株4076株。其中,CRKP 831株,占比为20.4%,CRKP主要来源为痰、尿、血,以腹腔引流液耐碳青霉烯肺炎克雷伯菌检出率最高,为22.4%~55.5%;3年间其对亚胺培南耐药率分别为19.3%、24.2%和22.4%,美罗培南耐药率为18.5%、23.1%和21.2%。CRKP对所测试全部抗菌药物耐药率均显著高于碳青霉烯类敏感肺炎克雷伯菌(CSKP)。氨基糖苷类、复方磺胺甲噁唑、头孢替坦对CRKP相对敏感,其他抗菌药物耐药率均高于90%,CS-KP对所测试全部抗菌药物耐药率均低于40%;2016年神经外科耐碳青霉烯肺炎克雷伯菌检出率由2015年3%上升至8%,集中在重症监护室(ICU),耐碳青霉烯酶基因型均为blaKPC-2型,选取神经外科ICU 10d内分离的5株CRKP进行MLST分型,均属于STll型。结论 3年间我院肺炎克雷伯菌耐药情况的变化及2016年在神经外科ICU病房出现的克隆传播,提示我们需采取有效的医院感染防控措施,进一步规范控制抗菌药物使用。     

Response of pulmonary cellular defenses to the inhalation of high concentrations of diesel exhaust

Rats were exposed to three concentrations of diluted diesel exhaust for 6 mo and 1 yr. Bronchopulmonary lavage was used to obtain the pulmonary phagocytes from the animals in order to study the response of the phagocytic defenses to the inhaled particulate. The cell numbers and volumes were measured using an electronic particle counter. The cell counts of alveolar macrophages (AM) were proportional to the concentration of diesel exhaust particulate (DP) in the chronic exposures. AM increased in the lungs in response to the rate of DP mass entering the lungs, rather than to the total DP burden in the lung. The geometric mean volumes of AM from the exposed and control animals were approximately 1100 micron3 at both 6 and 12 mo of exposure, although exposed cell-volume distributions skewed towards larger sizes. The AM volume distributions extended to 2000 micron3 in both control and 250 micrograms DP/m3 exposed animals and up to 5000 micron3 in cells from animals exposed to 750 and 1500 micrograms DP/m3. The volume distributions were found to be reproducible in equivalent control and exposed cell populations. Polymorphonuclear leukocytes were present in the lavaged cell populations from the animals exposed to 750 and 1500 micrograms/m3. In addition, at 1 yr of exposure, lymphocytes were also lavaged from animals exposed to 750 and 1500 micrograms DP/m3. Protein, beta-glucuronidase activity, and acid phosphatase activity were measured in the lavaged cells, and were elevated in the cells from animals exposed to 750 and 1500 micrograms/m3. The buoyant density of diesel-laden AM was found to be greater than that of control AM, and overlapped with the buoyant density of the polymorphonuclear leukocytes.     

人乳头瘤病毒在中国大陆女性的型别分布的Meta分析

目的 分析人乳头瘤病毒(human papillomavirus,HPV)型别在中国大陆女性中的分布特征.方法 检索万方数据库、中国期刊全文数据库、中国生物医学文献数据库收录的2009年1月至2016年1月我国女性大样本、一般人群的HPV型别相关研究,进行筛选、评估和数据提取,采用Meta分析法进行评价.结果 纳入31篇文献;HPV感染型别各地方一致,均在HPV16、HPV52、HPV58出现峰值,其中HPV16占所统计的19种HPV型别的9.77％～41.63％,HPV52占3.43％～28.68％,HPV58占5.29％ ～ 14.36％;HPV68、HPV6、HPV 11、HPV43只在个别地方出现峰值;其余几种HPV未见明显峰值.结论 中国大陆女性HPV感染型别以HPV16、HPV52、HPV58为主,HPV型别的分布存在明显的地区差异.     

低钾麻痹的临床特点分析

目的 观察低钾麻痹患者的临床特点以提高对该疾病的再认识。方法 回顾性总结本院收治的45例低钾麻痹患者的临床特点。结果 患者性别比为男：女=44：1,肢体麻痹时血钾〈3．5mmol／L,低血钾纠正后肢体肌力恢复。甲亢22例,亚临床甲亢3例,CK升高30例,房室传导阻滞5例。静脉补氯化钾1．5-5．5g,补钾治疗后肌力恢复的时间为3～30h,无后遗症。结论 低钾麻痹常见的病因之一是甲亢,男性多发,部分患者无典型高代谢症状,应把甲状腺功能测定列为常规检查,严重低钾血症可引起心律失常。补钾治疗过程中应严密观察肌力变化情况,及时复查血钾,避免医源性高钾血症发生。     

20例儿童局灶节段硬化性肾小球肾炎临床病理分析

探讨儿童局灶节段硬化性肾小球肾炎临床及病理特点。方法对２０例儿童ＦＳＧＳ患者的临床表现,病理改变以及对激素治疗的反应进行观察,并进一步分析三者间关系。结果儿童ＦＳＧＳ的发生率为５％。临床表现以浮肿及蛋白尿为主,肾病综合征占７０％高血压及肾功能不全分别占１０％、５％。     

跟骨骨折内固定手术并发症58例分析

目的 探讨跟骨关节内骨折内固定手术并发症的发生原因、预防和对策.方法 收集2004年9月至2009年7月在石河子市人民医院采用切开复位+"Y"形钢板内固定伴必要时自体植骨治疗的Ⅱ～Ⅳ型跟骨骨折58例(共64足)患者的临床资料进行回顾性分析.结果 采用Maryland足部评分标准评价手术效果:优良55足,优良率为85.9%,9足发生术后复位不佳、畸形愈合、切口延迟愈合、感染等并发症.发生明确的早期并发症6足,发生率15.5%.结论 跟骨骨折内固定手术并发症与其解剖特点和骨折机制有关,采取相应措施可有效减少并发症的发生.

Abstract：

Objective To discuss complications of the fixed surgery of internal fixation of intra- articular calcaneal fracture. Methods Totally 64 sides of calcaneal fracture in 58 patients were treated with open reduction and Y-shaped plate fixation through lateral approach. All the cases were followed up, and the associated complications were analyzed retrospectively. Results The clinical results were evaluated according to Maryland Foot Score.Excellent and good results were acchieved in 55 cases. The precentage of complication was 85.9%. The complications were foud in 9 cases, including postoprerative wound dehiscence,malunion,infection etc. Conclusions The complications of internal fixations treating fractures arc related to anatomic features of calcaneus.     

依达拉奉联合丁苯酞治疗急性脑梗死近期效果观察

目的观察依达拉奉联合丁苯酞治疗急性脑梗死的近期临床效果。方法选择本院2012年1～12月收治的63例急性脑梗死患者,根据治疗方法不同分为研究组与对照组．对照组21例患者给予常规治疗,研究组42例患者在常规治疗的基础上给予依达拉奉和丁苯酞治疗,两组疗程均为14d。治疗前后采用神经功能缺损程度评分（NIHSS）、Baahel指数评价治疗效果。结果研究组总有效率为88．1％：对照组总有效率为71．4％,两组差异有统计学意义（P〈0．05）,治疗后研究组NIHSS评分、Baahel指数明显低于对照组,差异有统计学意义（P〈0．05）。结论依达拉奉联合丁苯酞治疗急性脑梗死安全可靠,疗效明显优于常规治疗,具有临床推广价值。     

某医院门诊中成药处方的统计分析

目的：研究门诊处方对中成药的使用规律和特点,为临床更好地使用中成药提供参考。方法选取我院2011年12月1日～31日门诊处方,对含有中成药的处方进行统计分析,对其分布的科室、品种的使用频次和剂型分类进行统计。结果6个科室中成药处方比例较高,即较多使用中成药治疗相关疾病,4类中成药使用频次较高,2个现代剂型为使用的主要剂型。结论中成药治疗部分疾病具有明显的优势,现代剂型是门诊使用的主要剂型,体现了中成药的治疗特色。     

The Degree of Methylation and Organ Distribution of Mercury in Some Birds of Prey in Norway

Abstract The concentrations of total mercury and methyl mercury were determined in organs from several species of birds of prey. The organ distributions were calculated for each species. For total and non-methyl mercury, significant differences were found between the species. For methyl mercury no such differences were found. The liver: kidney ratios in White-tailed Eagle were 1:2.4 and 1:0.9 for total and methyl mercury, respectively. The corresponding figures for the Eagle Owl were 1:0.7 and 1:0.8. The distribution pattern and the degree of methylation were mainly dependent on the mercury levels, and there seemed to be an inverse relationship between the total mercury levels and the percentages of methyl mercury in the organs, especially in the kidney. There were good correlations between the methyl mercury concentrations in the liver, kidney, and muscle. The demethylation of methyl mercury seems to be a significant detoxication route for methyl mercury in birds of prey.     

我院病区药房退药情况调查分析

目的调查分析药房退药情况,减少退药,强化科学用药。方法对我院病区各科2012年10月¹2月退药原因、品种、金额等进行统计分析,并与2011年和2010年同期进行比较。结果 2012年10月12月退药原因、品种、金额等进行统计分析,并与2011年和2010年同期进行比较。结果 2012年10月¹2月共退药2 346例次,金额为478 937.43元,每例次平均退药195.00元;退药原因主要为患者出院、更改医嘱,要求退药;退药科室主要为脑血管科、呼吸科、儿内科及心内科等,占51.67%;退药品种主要为抗微生物药,占32.44%;该年4季度退药率3.45%。结论我院病区各科均有退药,其量大面广,品种多,原因复杂。今后应加强医院管理,制定相应措施,减少退药。     

我院妊娠期妇女门诊用药的合理性分析

目的:探讨我院妊娠期妇女门诊用药的合理性,促进临床合理用药。方法:利用医院信息管理系统,抽取首都医科大学附属北京世纪坛医院2019年1-12月全部产科门诊孕妇用药处方,对用药种类、用药频度(DDDs)、安全性级别及中成药使用情况进行统计和分析。结果:我院妊娠期妇女门诊最常使用的是维生素及微量元素类药品,其次为血液系统及激素类药品。安全级别较高的B类药品品种最多,未分级药品的使用情况基本合理,未使用X级药品。妊娠期妇女共使用中成药6种,其中说明书标识“可用”的有2种,说明书未注明的有4种,未使用说明书标识为“禁用”和“慎用”的中成药。结论:我院妊娠期妇女门诊用药总体较为合理,但在孕期使用某些中成药的安全性需进一步证实。     

不同产地黄芩中的有效成份含量分析

目的探讨不同产地黄苓中的黄芩苷、黄芩素、汉黄芩素的含量变化。方法制备供试品、对照品溶液,采用HPLC法,测定不同产地（河北承德、内蒙古自治区乌兰浩特、山西大同、吉林长白山）黄苓中黄苓苷、黄苓素、汉黄芩素的含量。结果黄芩苷、黄芩素、汉黄苓素含量测定方法的线性关系、重复性良好。精密度稳定。河北承德黄苓中黄芩苷含量最高,其次依次由高到低为：山西大同、吉林长白山、内蒙古自治区乌兰浩特;内蒙呼兰浩特的黄芩素、汉黄芩素含量最低,表明该地区收购的黄芩野生黄芩相对较多,其他产地的黄芩的黄芩素、汉黄芩素含量由高到低为：河南承德、山西大同、吉林长白山。结论不同产地的黄芩苷、黄芩素、汉黄苓素含量不同,临床用药应根据不同病症、不同产地调整药物剂量。     

颈椎关节突交锁的诊断与外科治疗

本文报告从1991年12月至2001年12月诊治的14例陈旧性颈椎关节突交锁患者,受伤至入院时间平均3.9个月(1～10个月)。脱位节段:C_(3～4) 2例,C_(4～5)4例,C_(5～6)5例,C_(6～7)3例。单侧脱位9例,双侧脱位5例。本组患者均有被误诊、误治的病史。在交锁关节突切除,脱位节段植骨融合的基础上,分别采用4种复位固定方法。术后随访平均2年8个月(6个月～5年3个月),9例患者中有7例神经症状有不同程度的改善。本文还对该病的诊断要点,误诊误治原因及目前的处理观点等问题作了讨论。     

加替沙星联合万古霉素治疗肠球菌性泌尿系感染24例

目的探讨加替沙星联合万古霉素治疗肠球菌性泌尿系感染的临床疗效和安全性。 方法住院的肠球菌性泌尿系感染患者48例采用随机配对法平分为对照组和治疗组，对照组给予万古霉素2.0 g·d^-1，静脉滴注，疗程14 d；治疗组给予加替沙星400 mg·d^-1，万古霉素10 g·d^-1，静脉滴注，疗程14 d。比较两组患者的临床疗效和不良反应发生率。结果对照组和治疗组临床治疗有效率分别为91.7%和87.5%(P＞0.05)，粪肠球菌对加替沙星的敏感率为72.7%，肠球菌清除率分别为83.3%和75.0%(P＞0.05)。对照组有3例出现肾功能异常，治疗组不良反应不明显。 结论加替沙星对粪肠球菌较敏感，联用万古霉素治疗肠球菌性泌尿系感染临床疗效良好，同时可减少万古霉素用量，降低不良反应，防止万古霉素耐药肠球菌的发生。     

Clinical evaluation of the efficacy of cefmetazole in respiratory tract infections of patients with underlying respiratory diseases

Respiratory infections of 10 subjects with underlying respiratory diseases were treated with cefmetazole (CMZ) and its clinical effects were studied. Five subjects of them were respiratory tract infection, 3 subjects were pneumonia and 2 subjects were pneumonia followed by empyema. The underlying diseases were chronic pulmonary emphysema in 4 subjects, diffuse panbronchiolitis in 3, chronic bronchitis in 2 and bronchial asthma in 1. The doses of CMZ were 4 to 8 grams per day and the durations of administration ranged 3 to 39 days. The clinical effects were judged from the changes of fever, cough, amount of sputum, dyspnea, rale, chest X-ray, white blood cell counts, erythrocyte sedimentation rates, sputum culture and PaO2. The clinical effects of 6 subjects were evaluated as good, those of 3 were fair and that of 1 was poor. In 3 subjects H. influenzae in the sputum was eliminated and in 1 subject both H. aphrophilus and alpha-Streptococcus found in the pleural effusion were eliminated. In 1 subject Klebsiella in the sputum was eliminated and replaced by Enterobacter. No side effects were observed. We conclude that CMZ is considerably useful in the treatment of respiratory infections of the patients with underlying respiratory diseases.